Description
Neurological issues in children can be very difficult to manage. Differentiating between the high and low risk can be challenging, but having a thorough understanding of pediatric practice guidelines can be very helpful in managing the children with neurological issues.
Our speaker gave an in detail explanation about the management of Pediatric Neurological Emergencies.
Résumé
- In pediatric neurology emergencies, presentations can be varied and may not always appear neurological. Initial assessment involves standard ABC (Airway, Breathing, Circulation) protocols, which is the primary intervention for any emergency.
- Seizures are a common neurological emergency. The most immediate action is to maintain airway safety, often achieved by placing the patient in the left lateral position to prevent aspiration. The immediate course of action for seizures is to maintain vitals first, stop the seizure second, and find and treat the underlying cause third.
- Acute limb weakness, altered sensorium, cranial nerve palsies, ataxia, and back pain in young children warrant immediate attention. Other symptoms such as new onset limb, pooling of secretions, and urinary retention are also considered emergency.
- For seizures, medications such as IV Lorazepam or intranasal/buccal Midazolam can be used if the seizure persists. Rectal Diazepam is less favored. It's crucial to avoid mixing multiple benzodiazepines to prevent respiratory depression. Also, don't forget the ABCG protocol, where you should monitor and correct low blood sugar if necessary.
- Guillain-Barré syndrome (GBS), an acute polyneuropathy, can present with ascending, symmetrical weakness. Prompt recognition and supportive care, including ventilation when needed, are crucial. Consider neuropathic pain management and the use of IVIG therapy.
- Infant botulism, often linked to honey consumption, causes descending weakness. Management primarily involves supportive care, as recovery can take months. Spinal muscular atrophy (SMA) should be considered in infants presenting with floppiness and respiratory issues.
- Duchenne muscular dystrophy (DMD) invariably affects the heart and is frequently involved with strokes. It is not only important but vital that we start them on cardio-protective treatment as early as possible. Other causes, include congenital heart disease and sequelae following chicken pox infections.
- Acute ataxia can result from various causes, including drug intoxication, post-infectious syndromes, and toxin exposure. Each cause has unique characteristics, so diagnosis can be achieved by using that knowledge.
Exemple de certificat
À propos des intervenants
Dr Ann Agnes Mathew
Neurologue pédiatrique consultant et spécialiste neuromusculaire au Synapse Neuro Centre
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